My Life and Death on Opioids

A mem­oir of ad­dic­tion

The Walrus - - CONTENTS - by Chris Wil­lie

A mem­oir of ad­dic­tion

In Novem­ber 2017, The Wal­rus started work­ing with Chris Wil­lie, a thirty-two-year-old en­vi­ron­men­tal and ex­er­cise phys­i­ol­ogy re­searcher, a univer­sity lec­turer in Bri­tish Columbia, and an ex­pe­ri­enced moun­tain climber. Wil­lie had re­cently com­pleted a mem­oir about his ex­pe­ri­ence with and re­cov­ery from fen­tanyl ad­dic­tion. He was eight months out of re­hab when he fin­ished his draft at the moun­tain and wilder­ness writ­ing res­i­dency at the Banff Cen­tre. But, on De­cem­ber 21, af­ter re­turn­ing from a climb­ing ex­pe­di­tion in South Amer­ica, Wil­lie re­lapsed and died due to a fen­tanyl over­dose. This ver­sion of his story is based on edit­ing con­ver­sa­tions with The­wal­rus be­fore his death and is pub­lished with the ap­proval of his fam­ily.

Com­ing to is like wak­ing up in an un­der­wa­ter car crash — a light­ning mo­ment in the crack of a missed heart­beat, breath erupt­ing in an agony of ter­ror. Sob­bing, gasp­ing for air, I’m be­wil­dered at the sight of waxy fin­gers claw­ing at the bath­room floor, fin­ger­nails chewed past the quick. My arm leaves a thin red smear along the toi­let’s edge as I prop my­self up: just a few more bits of me left be­hind. Alone. Be­yond the locked door of my staff bath­room, the happy chat­ter of stu­dents be­gins to re­gain form, and a spot of san­ity re­turns. I crawl up the sink to my feet and look to the face in the mir­ror,

all reds and grays and blues of a land­fill fire. Aban­doned eyes. You fuck­ing mo­ron. This is such id­iocy. You ob­vi­ously need to di­lute the fen­tanyl so you stop over­dos­ing.

Tau­gust 2017

he buga­boos are a clus­ter of spires in the Pur­cell Moun­tains of Bri­tish Columbia. Ev­ery sea­son for a decade, I have come here. The qual­ity and ac­ces­si­bil­ity of the climb­ing on the coarse gran­ite of the “Bugs” is world class, but it’s more than that which draws me. There is a peace here if you’re open to it—a place where I would sit in my tent and watch the sun pass be­hind Bu­ga­boo and Snow­patch Spires, cast­ing shad­ows on crenu­lated glaciers stri­ated crim­son by al­gae bloom­ing on their sur­faces. Opales­cent tarns turn down their blue for the night as shad­ows creep across pas­tel moraines. But if you stand in just the right spot, the sun will of­fer up its very last rays just for you. It’s early as I sit at the base of a rock wall with my boots off, toes dry­ing in the air. The sun warms my face, and I smile. I’m just over five months out of re­hab, where I was so weak I strug­gled with stairs, arms still bruised and scarred from months of con­stant nee­dles. I won­der if the mind ever fully heals from such abuse. I stuff morsels of brie and dried apri­cots into my mouth be­tween gulps of glacial wa­ter. It’s go­ing to be a thirsty day. I can trace my path from where I sit: a ver­ti­cal line where earth meets sky. It stops at a kilo­me­tre­high sweep of gran­ite, the top of which has just turned to gold un­der the first rays of the sum­mer sun. To the west, the sky is clear to the hori­zon, or nearly clear. Just a thin line of grey at the sky’s edge and the oc­ca­sional gust of toothy wind hints at in­com­ing weather, but there is still time.

I had left my tent at mid­night, skip­ping across the sharp tops of boul­ders in the dark, an un­seen path I knew by feel. By starlight, I climbed over the col be­tween Bu­ga­boo and Snow­patch Spires and across the bulging glacier be­neath the weep­ing west face of Pi­geon Spire, care­ful to avoid the crevasse that nearly swal­lowed me the year be­fore, back when I had not par­tic­u­larly cared. Now I look south­east across an ex­panse of Cana­dian wild that even­tu­ally emp­ties into the mas­sive lakes of the Koote­nay wilder­ness. Griz­zly bears and wa­ter. None of this is vis­i­ble in shadow, but I know the view well: the hang­ing ice cliffs that pe­ri­od­i­cally crash to the glacier be­low, the high spines of wind­blown snow, the var­i­ous me­an­der­ings of crevasses. I choose a safe line along the lower mar­gin of the glacier to avoid un­seen holes in the dark, and I drink from a wa­ter­spout at its end. I reach a spine of frac­tured rock that drops straight south, just as the starlight dims in the fuzzy glow of dawn. Ac­cess to the west face of the North Howser Tower, the big­gest face in the Buga­boos, is guarded by a great ser­rated fin, and it can be a place of crush­ing doubt. Once you rap­pel down its side — ten times the height of the Statue of Lib­erty — the only es­cape is to ei­ther climb a kilo­me­tre of gran­ite or re­treat and cir­cum­nav­i­gate the moun­tain over tum­bling glaciers full of holes. A grim prospect, and one that’s es­pe­cially dire if at­tempted alone. For years I’ve dreamed of it, and now here I am. I left re­hab bro­ken and low, but now my heart is full of self-re­spect, and I’m hap­pily snack­ing and warm­ing my toes, about to de­scend to the base of North Howser Tower. My gear is care­fully spread at my feet, left to right: eight bright cams — stubby climb­ing screws — and six nuts ar­ranged by size, five white shoul­der-length slings, one red sev­enty-me­tre rope, a green be­lay de­vice, orange cram­pons, and my favourite chalky climb­ing shoes. It is a risky thing to climb a moun­tain, par­tic­u­larly alone, but I fi­nally feel wor­thy of this path and am still amazed to be alive to seek it. I do not want to die, but if I do, this view sure as hell beats the one of that empty man in the bath­room mir­ror.

Ev­ery­one goes through breakups, but some peo­ple have a flair for the per­sonal im­plo­sion that fol­lows. Then again, re­la­tion­ships are never equally cast. Some are such re­splen­dent mon­u­ments to friend­ship and trust that when they crum­ble, they pro­duce aching tragedy. Four years ear­lier, I had locked eyes with a woman — and ev­ery fan­tas­ti­cal plan I had held for the fu­ture was in an in­stant con­densed into her brown-eyed side­ways glance. Three years later, I found my­self mar­ried to a vi­sion of our fu­ture, but it was one that we in­creas­ingly did not share. We moved from Kelowna to Van­cou­ver, where I strug­gled with a lack of di­rec­tion. Lit­tle is less at­trac­tive than a man just hang­ing on, and our re­la­tion­ship slid to op­po­site sides of the bed. We fi­nally re­al­ized that our re­la­tion­ship was over, and it was in opioids that I later found the af­fec­tion and re­lief that I craved. The hu­man mind is a won­drous liq­uid ex­per­i­ment: a sys­tem of or­ga­nized chem­i­cals that grows it­self into the fu­ture, like plants with roots in time. Mo­ti­va­tion be­gins deep in the brain, where a neu­ro­chem­i­cal caul­dron of past ex­pe­ri­ences, present morale, and fu­ture goals co­a­lesce to stim­u­late a par­tic­u­lar be­hav­iour: I want that. This de­sire for some­thing blooms as an iso­lated elec­tri­cal ex­plo­sion from some cells in your core, the place your feel­ings are born into your

world. Which is to say, the ba­sis for mo­ti­va­tion is a pri­mal thing in a wan­ton pur­suit of prey. The big drugs — co­caine, opioids, metham­phetamine — in­fect this mo­ti­va­tion, wrap you ten­derly in a warm dopamine blan­ket, and then drag you by your an­kle be­hind a ru­n­away horse. In the United States, there are now more deaths from over­doses than car crashes or gun vi­o­lence: over­doses are the lead­ing cause of death for Amer­i­cans un­der the age of fifty. In Bri­tish Columbia, more peo­ple died from over­doses in 2016 than of Alzheimer’s, chronic liver dis­ease, and sui­cide. It’s es­ti­mated that fa­tal opi­oid-re­lated over­doses have tripled since the start of this mil­len­nium. But pre­con­cep­tions die hard. No one sus­pects chron­i­cally con­stricted pupils, long sleeves, and drowsi­ness in a doc­tor or lawyer or pro­fes­sor as any­thing but the signs of over­work. And so­ci­ety’s view that hard drugs are prin­ci­pally the vice of city ghet­tos has per­sisted de­spite ev­i­dence that these sub­stances are more wide­spread. In ar­eas par­tic­u­larly rav­aged by opioids, such as Van­cou­ver and Hunt­ing­ton, West Vir­ginia, the prob­lem is so com­mon that if a funeral is de­layed due to an au­topsy back­log, it is of­ten as­sumed that the de­ceased died of over­dose. The as­sump­tion that a sin­gle hit of heroin will cause a life­time ad­dic­tion is more the re­sult of things like Richard Nixon’s war on drugs than of phar­ma­col­ogy. If Nixon’s per­cep­tions were strictly true — that drugs are highly ad­dic­tive and that all ad­dicts are crim­i­nals — ev­ery pa­tient ever given mor­phine would be out there steal­ing purses to feed their need for more. There are all man­ner of data on the ef­fects of heroin on the minds of mam­mals, but on one point many agree: in­fant stress can pro­duce an adult brain with a height­ened re­sponse to opioids and greater ten­dency to­ward ad­dic­tive be­hav­iours. In a study done in the 1970s, for ex­am­ple, it was found that rats who were iso­lated from other rats will choose wa­ter laced with drugs. By com­par­i­son, when the rats were in­tro­duced to a highly so­cial en­vi­ron­ment, called “Rat Park,” and given two seem­ingly iden­ti­cal wa­ter sources, they avoided the wa­ter laced with mor­phine. It wasn’t a de­fin­i­tive study, but it showed that en­vi­ron­ment does play a role in ad­dic­tion. Hu­mans, too, will take to be­hav­iours and chem­i­cals that al­ter our in­ter­ac­tion with the world in or­der to numb in­ter­nal strife. Sub­stance abuse is the at­tempt to ex­trin­si­cally al­ter our in­ter­nal ex­pe­ri­ence — our per­cep­tion of the world — to es­cape pain. Tak­ing con­trol of our in­ter­nal cli­mate is called cop­ing, and the bet­ter our cop­ing mech­a­nisms are, the less ur­gent our need for es­cape. I have never ex­celled at cop­ing. I was that in­fant child who ham­mered his head on the ground when frus­trated by any­thing at all. It must have been em­bar­rass­ing to par­ent the son with the ev­er­p­re­sent fore­head scabs. Per­haps I found it sooth­ing, be­cause, thirty years later, I still find seren­ity in chaos and de­rive calm from risk. And I oc­ca­sion­ally still bang my head in frus­tra­tion. I also love es­cape — those fused states of mind and body, of cog­ni­tive fo­cus and car­nal in­stinct: mo­tor­cy­cling and climb­ing and ski­ing and sex. Such sen­sa­tion seek­ing can be both a key in­stru­ment for suc­cess and a po­ten­tially fa­tal flaw. Suc­cess if the trait helps achieve some­thing of value and a flaw, ob­vi­ously, if fa­tal. Yet the great­est achieve­ments of my life have been in­her­ently risky: from climb­ing to the sum­mits of tow­er­ing moun­tains to scrap­ping so­cial norms — I lived in a van to pur­sue climb­ing. Are these valu­able only by virtue of sur­vival?

Ioc­to­ber 2013

n a med­i­cal school lab­o­ra­tory in Split, Croa­tia, a pro­fes­sional diver has just com­pleted a five-minute breath hold, or vol­un­tary ap­nea. I’m with a team of sci­en­tists from across the planet that is mon­i­tor­ing the diver’s car­dio­vas­cu­lar sys­tem’s re­sponse to mas­sive stress. She’s part of a group of peo­ple ca­pa­ble of achiev­ing some­thing that should not be pos­si­ble. The top ap­nea divers of the world can main­tain a breath hold un­til blood-oxy­gen lev­els drop so much that the brain be­gins to mal­func­tion; eu­pho­ria some­times fol­lows, which some liken to an or­gasm with a dash of heroin. Her chest is heav­ing, her lips blue with the need for air, and when she fi­nally breathes, she slack­ens and lets out an ex­hausted whisper, “That was so beau­ti­ful.” Lit­tle won­der that ap­nea divers are fa­nat­i­cal in their pur­suit of ever-longer breath holds and ever-deeper dives in the quest for the per­fect, ephemeral fix. I have spent my life chas­ing one hardto-reach en­deav­our af­ter an­other and then for­get­ting about the ac­com­plish­ment in my wide-eyed pur­suit of the next one. It was there in the fear­less aban­don I har­nessed to race moun­tain bikes down­hill as a teenager. It jus­ti­fied the to­tal ded­i­ca­tion and cost to men­tal health with which I pur­sued ul­ti­mately un­ful­filled plans to be a sur­geon. And it spurred me to climb rock faces and frozen wa­ter­falls to high, stormy sum­mits. This is the sin­gu­lar fix­a­tion of a search for the next fix, like the ap­nea diver who chases the eu­pho­ria. Any de­crease in avail­able oxy­gen, whether due to dis­ease, high al­ti­tude, or erotic as­phyx­i­a­tion, is termed hy­poxia. While you or I can likely man­age a breath hold of around a minute, elite ath­letes in the es­o­teric world of ap­nea div­ing can com­plete breath holds of ten min­utes or more, a mas­sive dif­fer­ence that ques­tions some fun­da­men­tal prin­ci­ples of phys­i­ol­ogy — namely the one that says the brain needs con­sis­tent oxy­gen to func­tion. This was the ques­tion that brought me to Croa­tia. With my fo­cus on brain vas­cu­lar phys­i­ol­ogy, I’d been study­ing hu­mans in en­vi­ron­men­tal ex­tremes — heat, high al­ti­tude, un­der­wa­ter —around the world. I had found this zany world of phys­i­ol­ogy nearly a decade be­fore, at­tracted as much by the sci­ence as by the peo­ple ex­plor­ing it. Ev­ery dis­ci­pline in sci­ence at­tracts dif­fer­ent types, and cere­brovas­cu­lar phys­i­ol­o­gists tend to have a wild streak. The pur­suit of al­tered states is uniquely hu­man. Sure, lab rats some­times pre­fer drugs to wa­ter; some mon­keys and in­sects will get drunk on fer­mented fruit. But only peo­ple pos­sess the so­phis­ti­cated lu­nacy to seek obliv­ion through as­phyx­i­a­tion, or a nee­dle and some dodgy kitchen chem­istry. Which is ex­actly how, years later, I would find my­self naked, red as a sun­burned tourist, and cov­ered in hives, rac­ing around my room in Squamish, BC, cer­tain that my hair­less head had

above Chris Wil­lie climb­ing in the Cerro Torre moun­tain of South Amer­ica’s south­ern Patag­o­nian ice field the month he died. photo courtesy o f Quentin Roberts

above Chris Wil­lie climb­ing in Squamish, BC, in Jan­uary 2017. photo courtesy o f chris wil­lie/in­sta­gram

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